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Antiepileptic / Mood stabiliser

Sodium Valproate

Brand names: Epilim, Episenta, Depakote (valproic acid)

Used in: Seizures & Epilepsy

Sodium valproate is a broadly effective antiepileptic (also used in bipolar disorder) — but it is subject to strict pregnancy restrictions.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Valproic acid oral solution is intended for oral administration. ( 2.1 ) Simple and Complex Absence Seizures: Start at 10 to 15 mg/kg/day, increasing at 1 week intervals by 5 to 10 mg/kg/week until seizure control or limiting side effects ( 2.1 ) Safety of doses above 60 mg/kg/day is not established ( 2.1 , 2.2 ) 2.1 Epilepsy Valproic acid oral solution is intended for oral administration. Patients should be informed to take valproic acid oral solution every day as prescribed. If a dose is missed it should be taken as soon as possible, unless it is almost time for the next dose. If a dose is skipped, the patient should not double the next dose. Valproic acid is indicated as monotherapy and …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2024-05-27. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It increases GABA activity and affects sodium channels, reducing neuronal excitability.

Prescribing in practice

  • It is highly teratogenic (major malformations and neurodevelopmental harm) and must not be used in girls or women of childbearing potential unless the conditions of the Pregnancy Prevention Programme are met — with regulators further restricting new initiations; specialist involvement is required.
  • Serious hepatotoxicity (rare) and pancreatitis occur; also thrombocytopenia, weight gain, tremor and hair changes.
  • It inhibits the metabolism of lamotrigine (raising the risk of serious rash) and has other interactions.

Monitoring

Monitor liver function (especially early) and FBC; in those who could become pregnant, confirm the pregnancy-prevention conditions.

Counselling the patient

  • If you can become pregnant, this medicine carries serious risks to a baby — do not stop it suddenly, but seek urgent specialist advice about contraception and alternatives.
  • Report abdominal pain, vomiting, unusual bruising or yellowing of the skin/eyes.

Evidence & guidelines

A broadly effective antiepileptic (NICE NG217) constrained by MHRA pregnancy-prevention requirements.

Reference: MHRA Drug Safety Update (valproate); NICE CG137; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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